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Kaiser Daily Global Health Policy Report

In The News

Ebola Death Toll Surpasses 4,000, WHO Reports

News outlets report on the WHO’s announcement that the Ebola death toll has surpassed 4,000.

Agence France-Presse: Ebola toll passes 4,000 as fears grow worldwide
“The death toll from Ebola has passed 4,000, the World Health Organization said Friday, while a Madrid nurse was fighting for her life and authorities worldwide tried to prevent panic over the deadly disease…” (Parry/Bazinet, 10/10).

Agence France-Presse: Authorities try to prevent panic as Ebola toll passes 4,000
“…The World Health Organization (WHO) says 4,033 people have died from Ebola as of October 8 out of a total of 8,399 registered cases in seven countries. The sharp rise in deaths came as the U.N. said aid pledges to fight the outbreak have fallen well short of the $1 billion (800 million euros) needed…” (Parry, 10/11).

Associated Press: WHO: Ebola death toll above 4,000
“The total number of deaths attributed to the Ebola outbreak in West Africa has risen above 4,000, the World Health Organization said Friday. The Geneva-based U.N. agency said that 4,033 deaths confirmed, probably or suspected to have been caused by Ebola have now been recorded…” (10/10).

The Hill: Ebola death toll tops 4,000
“…The figure is the latest sign that the deadly virus is spreading rapidly. One-quarter of the Ebola deaths have occurred since Sept. 28, and at least 10 cities have reported more than 200 cases…” (Ferris, 10/10).

Wall Street Journal: Ebola Death Toll Surpasses 4,000, Says WHO
“The death toll from the current Ebola outbreak has topped 4,000, the World Health Organization said, adding the first reported death in the U.S. and including Spain to the list of nations where the virus has been detected…” (Maclucas, 10/11).

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High-Level Officials From U.N., Financial Institutions, U.S. Administration Call For Increased Ebola Efforts, Funding

News outlets report on comments on the Ebola epidemic from high-ranking officials from the U.N., financial institutions, and the U.S. administration.

Reuters: United Nations says $1 bln Ebola appeal only one quarter funded
“The United Nations said on Friday that its appeal for $1 billion to respond to the West Africa Ebola outbreak was only 25 percent funded and a surge in trained health care personnel was also needed to help tackle the crisis…” (10/10).

Wall Street Journal: World Bank Calls for Emergency Fund for Disease Outbreaks
“The World Bank Group faulted the slowness of the global response to Ebola and called Friday for an international fund to distribute money quickly to affected countries…” (Mauldin, 10/10).

Agence France-Presse: Lagarde: don’t isolate Africa over Ebola
“IMF chief Christine Lagarde on Saturday pleaded with people to remember that all of Africa has not been hit with the deadly Ebola epidemic, which remains relatively isolated in three countries…” (10/11).

Reuters: Ebola funds should not be repackaged aid, Africa bank chief says
“The head of the African Development Bank expressed concern on Saturday that some donors responding to the Ebola crisis were repackaging aid money, funneling it away from other areas in need in the three countries at the center for the epidemic…” (Wroughton/Toweh, 10/11).

U.N. News Centre: ‘We are late, but not too late to fight and win this battle,’ against Ebola — U.N.
“Declaring that the world has never seen anything like the current Ebola outbreak ravaging West Africa, senior United Nations officials today warned that the virus is ‘far ahead’ of the global response as it is morphing from a local to an international crisis requiring all countries to scale up efforts and financial commitments to bring an end to the scourge…” (10/10).

The Hill: Administration points fingers on Ebola
“White House National Security Advisor Susan Rice says other countries ‘haven’t done enough’ to help stop the deadly disease Ebola from spreading. ‘We are pushing very hard for everybody to do more. This is going to take all hands on deck,’ she told NBC’s Chuck Todd, in an interview set to air Sunday on ‘Meet the Press’…” (Wilson, 10/11).

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Countries Worldwide Step Up Efforts To Prevent, Prepare For Ebola Within Their Own Borders

News outlets report on efforts in countries worldwide to prevent the importation of Ebola and prepare for cases within their borders.

Agence France-Presse: Nations step up measures to stem worsening Ebola outbreak (Perry, 10/12).
Agence France-Presse: Britain feels ready after Ebola outbreak test (10/11).
Devex: Is Asia-Pacific ready for Ebola? (Santos, 10/13).
New York Times: CDC Will Offer More Ebola Training to Health Care Workers (Belluck, 10/12).
Politico: Questions emerge about Ebola readiness (Levine, 10/13).
Reuters: Cities, states scramble after Dallas’s Ebola missteps expose planning gaps (Begley/Abutaleb, 10/12).
Reuters: Obama calls for action to ensure U.S. medical system can handle Ebola (10/12).
Wall Street Journal: New York Health System Opts for WHO Ebola Protocol (Beck, 10/12).

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CDC Confirms Second U.S. Ebola Case As Dallas Health Worker Tests Positive For Virus

News outlets report on the CDC’s confirmation that a Dallas health worker who treated a Liberian man who died of Ebola last week has tested positive for the virus, marking the first case of Ebola transmission in the U.S.

Associated Press: Dallas health worker tests positive for Ebola (Merchant, 10/13).
The Atlantic: A Dallas Nurse Becomes the First Person to Contract Ebola on U.S. Soil (McDuffee, 10/12).
The Hill: CDC confirms second U.S. Ebola case (Balluck, 10/12).
New York Times: 2nd Ebola Case in U.S. Stokes Fears of Health Care Workers (Fernandez, 10/12).
Reuters/Newsweek: Second U.S. Ebola Case: Texas Health Care Worker Tests Positive (10/12).
Wall Street Journal: Ebola Virus: Texas Health Worker Tests Positive, CDC Confirms (Mckay et al., 10/13).
Washington Post: Health worker who treated Dallas patient tests positive for Ebola (Dennis et al., 10/12).

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U.S. Officials Comment On Dallas Ebola Cases, Research Into Vaccines

News outlets report on U.S. health officials’ statements about the U.S. Ebola cases and research for a vaccine.

Agence France-Presse: First U.S. Ebola infection result of ‘protocol breach’
“A Texas health care worker has become the first person to contract Ebola on American soil, authorities confirmed, blaming a safety breach for the spread of the deadly disease…” (Sheridan, 10/12).

Deutsche Welle: Health bosses cite ‘breach of protocol’ in latest Ebola case
“The female health care worker who tested positive for Ebola caught the disease because of a lapse in protocol, according to the director of the U.S. Centers for Disease Control and Prevention (CDC), Thomas Frieden…” (10/12).

The Hill: CDC director: More Ebola cases possible
“…The CDC is sending more staff to Texas to ‘assist in this response,’ which includes opening an investigation to figure out how the worker became infected and how health workers at the Dallas hospital treat diseased patients…” (Wilson, 10/12).

The Hill: NIH official: ‘The system worked’
“Following news that a health care worker in Dallas has tested positive for Ebola, a top official at the National Institutes of Health said Sunday that the ‘system worked.’ ‘This was a breach in protocol,’ Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said on ABC’s ‘This Week’…” (Balluck, 10/12).

The Hill: Health official: Ebola travel bans would be ‘counterproductive’
“A top U.S. medical official warned Sunday that barring travel from countries facing an Ebola outbreak could do more harm than good. Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said the push to isolate those countries could worsen the outbreak, which in turn could cause it to spill to neighboring regions and make it that much harder to control…” (Schroeder, 10/12).

Huffington Post: Ebola Vaccine Would Likely Have Been Found By Now If Not For Budget Cuts: NIH Director
“…Dr. Francis Collins, the head of the National Institutes of Health, said that a decade of stagnant spending has ‘slowed down’ research on all items, including vaccinations for infectious diseases. As a result, he said, the international community has been left playing catch-up on a potentially avoidable humanitarian catastrophe…” (10/12).

Reuters: CDC head criticized for blaming ‘protocol breach’ as nurse gets Ebola
“Some health care experts are bristling at the assertion by a top U.S. health official that a ‘protocol breach’ caused a Dallas nurse to be infected with Ebola while caring for a dying patient, saying the case instead shows how far the nation’s hospitals are from adequately training staff to deal with the deadly virus…” (Steenhuysen, 10/13).

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Proper Procedures, Gear, Training Necessary To Protect HCWs When Treating Ebola Patients

News outlets report on the challenges of protecting health care workers who treat Ebola patients.

The Guardian: Challenge of keeping frontline Ebola healthcare workers alive
“Health workers on the Ebola frontline are and always have been at the highest risk of contracting the disease. … But in countries such as the U.S. and Spain, which have sophisticated health care systems and well-equipped hospitals, health care workers should be safe. It is shocking that workers in Spain and now Texas have contracted Ebola from patients they were treating…” (Boseley, 10/12).

ScienceInsider: Ebola infection in Dallas nurse underscores critical need for proper training
“…The [Dallas nurse Ebola] case has similarities to that of a nurse infected in a Spanish hospital after taking care of a priest who had contracted the disease in Sierra Leone, and both raise questions about the training procedures that hospital staff receive before they come into contact with Ebola patients…” (Cohen, 10/12).

Scientific American: Ebola Spread Shows Flaws in Protective Gear and Procedures
“Physicians, nurses and other medical staff who are the first line of defense against the spread of Ebola are not always adequately protected from the virus, a situation that has contributed to more than 200 health worker deaths in West Africa since the outbreak began in December 2013. As the virus spreads outside of Africa, so do reports that problems with procedures, protective equipment, and training for using that equipment are putting health workers at risk…” (Greenemeier, 10/10).

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E.U. Health Ministers To Attend Ebola Meeting This Week

Reuters: E.U. calls extraordinary meeting of health ministers over Ebola
“European Union health ministers will convene in an extraordinary meeting next week in Brussels to discuss increasing precautions against the deadly Ebola outbreak in West Africa, Italy’s health ministry said on Friday…” (Scherer, 10/10).

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Sierra Leone, Liberia Face Challenges In Controlling Ebola Epidemic

News outlets report on challenges faced in responding to the Ebola epidemic in Liberia and Sierra Leone, two of the worst-hit nations.

New York Times: Officials Admit a ‘Defeat’ by Ebola in Sierra Leone
“Acknowledging a major ‘defeat’ in the fight against Ebola, international health officials battling the epidemic in Sierra Leone approved plans on Friday to help families tend to patients at home, recognizing that they are overwhelmed and have little chance of getting enough treatment beds in place quickly to meet the surging need…” (Nossiter, 10/10).

New York Times: Amid Ebola Crisis, Liberian Army Sees Its Chance at Rebranding
“…[The Armed Forces of Liberia] — once responsible for toppling the government, killing civilians, and setting the nation on a course toward a devastating civil war — have suddenly become a linchpin in the fight against the Ebola virus rampaging through their country. … Replacing such images in the public consciousness with ones of Liberian soldiers working side by side with American troops and making nice with ordinary Liberians is a tough sell, even if the enemy now is a terrifying virus steamrolling through the country, killing more than 2,300 people in six months…” (Cooper, 10/11).

Wall Street Journal: Some Ebola-Stricken African Families Pay Bribes for Fake Death Records
“Some of the teams sent to retrieve bodies of suspected Ebola victims here are collecting cash instead, allegedly accepting bribes to issue death certificates to families saying their loved ones died of other causes and leaving the body, locals and health workers say…” (Vogt, 10/12).

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News Outlets Examine Issues Surrounding Ebola Treatment Research, Vaccine Development, Case Detection

News outlets discuss issues surrounding the research and development of Ebola treatments and vaccines, as well as the challenges of case detection.

Agence France-Presse: Use of placebos in Ebola drug trials unethical: experts
“Health experts from around the globe said Friday it would be unethical in drug trials to give non-active placebos to people infected with the killer Ebola virus…” (10/10).

Agence France-Presse: Three Russian Ebola vaccines ready within six months: Moscow
“Russia expects to produce three Ebola vaccines within the next six months, Health Minister Veronika Skvortsova said on Saturday…” (10/11).

Los Angeles Times: Ebola research: Fever not a surefire sign of infection
“For public health workers screening more than 1,000 air travelers who arrive each week in the United States from Ebola-stricken West Africa, one symptom above all others is supposed to signal danger: fever. So long as an individual’s temperature does not exceed 101.5 degrees and there are no visible symptoms of Ebola, health authorities say it should be assumed the person is not infectious. Yet the largest study of the current outbreak found that in nearly 13 percent of ‘confirmed and probable’ cases in Liberia, Sierra Leone, Guinea, and elsewhere, those infected did not have fevers…” (Willman, 10/12).

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Nigeria Sets Tone For Successful Public Health Response To Ebola

The Atlantic: How Nigeria Beat Ebola
“At least one African country has been able to fight back against Ebola: Nigeria, West Africa’s largest and most developed nation, has set the tone for a successful public health response to the frightening and often-misunderstood disease. Faisal Shuaib is a Nigerian physician and public health expert who works for the Nigerian Health Ministry as the deputy incident manager of the country’s polio eradication program supported by the Gates Foundation. … Shuaib spoke with me this week about his work in Nigeria and how to prevent this crisis from becoming a pandemic…” (Fernholz, 10/10).

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U.N., NGOs Recognize International Day Of The Girl Child

News outlets report on the International Day of the Girl Child, recognized annually on October 11.

The Guardian: Day of girl child marked by clarion call to ‘walk the walk’ on gender equality
“Despite new legislation and proactive policies such as quotas, the world is failing to deliver on equality between girls and boys, according to a report that calls for a sea change in attitudes across society as well as sustained, vocal support for grassroots movements…” (Chonghaile, 10/10).

NPR: A Day For Global Girls Gets People Talking, But Then What?
“Tomorrow marks the third International Day of the Girl Child, designated by the U.N. to highlight the need to create a better world for adolescent girls. … But these days, it seems like every other day is the International Day of this, that, or the other thing. … It makes you wonder: How effective are these commemorative days? Goats and Soda asked a few scholars who specialize in global issues. Their answers were decidedly mixed…” (Poon, 10/10).

U.N. News Centre: Ahead of International Day of the Girl Child, U.N. urges end to violence against women, girls
“The United Nations has paid tribute to the almost one billion young and adolescent girls living around the world as many of them continue to face daily challenges to their development and overall diminished potential due to the enduring scourge of gender discrimination and violence…” (10/10).

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Bill Gates Discusses Ebola Crisis, Global Health Issues In Interview

OZY: Bill Gates’ ‘Big Idea’ on Ebola
“OZY sat down with billionaire tech wizard and philanthropist Bill Gates this week for an exclusive interview. Co-founder and CEO Carlos Watson asked Gates to tell us about whether, after investing so much time and money in global health issues, there is still more that could or should be done to combat the crisis…” (Watson, October 2014).

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Activists Say Africa Can End FGM In 20 Years

Thomson Reuters Foundation: Africa can end ‘child abuse’ of FGM by 2035: activists
“Africa can end female genital mutilation (FGM) in 20 years, activists said on Friday as they launched a continent-wide campaign, calling the ancient ritual a form of child abuse aimed at controlling women’s sexuality…” (Migiro, 10/10).

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Ban Calls For Improved Care For Schizophrenia On World Mental Health Day

U.N. News Centre: On World Mental Health Day, Ban calls for improved care for schizophrenia
“Suffering from schizophrenia should not have to mean enduring ‘a life sentence of isolation and poor physical health,’ Secretary-General Ban Ki-moon said [Friday] as he urged the creation of better support networks and services for people living with the mental health disorder…” (10/10).

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Swaziland King To Use World Bank HIV Funds To Pay Girls To Remain Virgins

International Business Times: Swaziland King Pays Girls $18 a Month to Remain Virgins; Uses World Bank HIV Funds
“Swaziland’s King Mswati III has reportedly announced to pay all teenage girls in the South Africa kingdom a monthly stipend of 200 rands ($18) for abstaining from sex and remaining a virgin. The funds for the projects are financed by the World Bank for tackling HIV/AIDS…” (Varghese, 10/9).

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Editorials and Opinions

Editorials, Opinion Pieces Discuss Aspects Of Ebola Epidemic

The following editorials and opinion pieces discuss various aspects of the Ebola epidemic.

Bloomberg View: Africa’s Ebola and Asia’s Obligation
Editorial Board

“…With more than 8,000 documented [Ebola] cases and 4,000 reported deaths in West Africa, the epidemic is outstripping international efforts to contain it — and Asian countries in particular have compelling reasons to respond. … Together with the economic consequences, the risks of Ebola going unchecked are arguably greater for Asia than any other part of the world [because of the threat of infection in its dense population centers]. … But the argument goes beyond economics and self-interest, and for Asians, the moral case for more involvement may have special relevance. … All of this makes the paltry response to date of some Asian nations so disappointing…” (10/12).

The Lancet: Ebola: what lessons for the International Health Regulations?
Editorial Board

“…Despite [prevention and treatment] efforts, Ebola is staying ahead of efforts to contain it. In such a situation, although it is understandable to focus on urgent actions, it would be a mistake not to reflect on how we arrived at this situation and what we need to do to prevent it from happening again. The International Health Regulations (IHR) represent the system designed to prevent national public health emergencies from becoming international crises. … Two priorities stand out. First, an urgent donor conference must be convened to discuss the implications of the Ebola epidemic and the international community’s failure to invest in the IHR. … Second, a robust mechanism must be put in place to guarantee independent monitoring and review of country implementation of the IHR…” (10/11).

Huffington Post: Inside the Heart of an Epidemic
Carolyn Miles, president and CEO of Save the Children

“…One of the key pieces of our response [to Ebola] is to work with the Department of Social Welfare in Liberia to ensure we know where these [orphaned or abandoned] children are and get them basic survival kits, which include food, household items, soap and hygiene supplies, and clothing. Then we begin to try to reunite them with extended family whenever and wherever possible, a painstaking process to trace family members that may be hundreds of miles away…” (10/10).

New York Times: How to Quarantine Against Ebola
Siddhartha Mukherjee, assistant professor of medicine at Columbia University

“…Rather than relying on primitive instruments, indiscriminate profiling or questionnaires, we should consider running a pilot program to test asymptomatic travelers using sensitive [polymerase chain reaction (PCR)]-based techniques. … Huge logistical questions would need to be solved … [but] we should develop a pilot program, perhaps targeting the worst-hit regions of the epidemic…” (10/12).

SF Gate: How to put an Ebola treatment on drugmakers’ radar
David Ridley, faculty director of the Health Sector Management program at Duke University’s Fuqua School of Business

“…Sadly, Ebola has been largely ignored by drugmakers because there’s little profit potential for a drug that primarily treats people in poor countries. But there is a law on the books that offers financial incentives to drugmakers to develop treatments for 16 other neglected diseases. And there is a window now open to add Ebola to that list. … Under the current voucher program, the developer of a novel drug for a neglected disease receives an expedited six-month review by the FDA, as well as a bonus priority review voucher that can be sold to another company for use on a different drug. One of those vouchers was sold this year for $67.5 million. … With the 21st Century Cures Initiative, Congress now has an opportunity to enable the voucher program to save more lives” (10/12).

Nature: Before Ebola, Health Officials Thought the Age of Epidemics Was Over — It Wasn’t
Annie Sparrow, assistant professor and deputy director of the Human Rights Program at the Arnhold Global Health Institute at Mount Sinai in New York

“…On WHO’s watch, not only has Ebola thrived to the point of a panic-inducing epidemic, with cases across several countries and in three continents, but polio, once on the verge of eradication, is making a global comeback and mutating into new and lethal mutations. Better leadership is clearly needed, as well as a global commitment to focus WHO on the parts of the world that need its help the most. Closer to home, we must learn how to recognize not only Ebola but polio, measles, and other diseases regaled to history books. … Finally, and perhaps most important of all, we should be investing in the public-health institutions in places like West Africa in order to prevent and, if necessary, respond more quickly to threats of communicable disease than a distant U.N. institution in Geneva…” (10/10).

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Tackling TB In India Requires Both Public, Private Sector Engagement

The Hindu: Fighting India’s silent epidemic
Soumya Swaminathan, director of the National Institute for Research in Tuberculosis in Chennai, and Chapal Mehra, New Delhi-based writer

“Over 60 percent of all Indians seek health care in the private sector, according to India’s last National Family Health Survey. … Even though parallel providers of health services, the absence of partnerships between the public and private sector has disastrous implications for patients and for disease control. A striking case study is that of TB. … In 2013, the World Health Organization identified three million missing TB cases globally of which one million were in India. These one million missing cases fall somewhere between the public and the private sector and lack access to free care. If India wishes to end its TB crisis, we must begin by providing prompt diagnosis and treatment to our missing million. Yet this is unlikely to happen unless we transform our current TB program while simultaneously engaging the vast private sector. If we do not act now, our inaction will make us responsible for continued suffering of patients and deaths” (10/13).

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Bangladesh Serves As Model For Reducing Maternal Mortality

The Lancet: Challenges of achieving and tracking MDG 5
Saifuddin Ahmed of Johns Hopkins University Bloomberg School of Public Health

“…No woman should die from pregnancy complications. That women still die from preventable and treatable maternal causes is our egregious failure. Bangladesh has set an example of a country that has successfully reduced maternal mortality, and might well serve as a model for maternal mortality reduction that other resource-poor countries can emulate. Bangladesh also shows that the challenges of reliable estimation of maternal mortality can be surmounted. We must act to achieve the goal of drastically reducing maternal mortality, and do more to improve data collection for tracking progress” (10/11).

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From the Global Health Policy Community

Press Releases, Blog Post Discuss U.S. Reponse, World Bank Report On Ebola

The following press releases and blog post discuss U.S. efforts to contain Ebola and a new World Bank report on the disease’s potential economic impacts.

USAID: USAID Administrator Shah Travels to Liberia, Sierra Leone, Guinea, and Senegal
“U.S. Agency for International Development (USAID) Administrator Rajiv Shah will travel to Liberia, Sierra Leone, Guinea, and Senegal Oct. 13-17, to meet with national and local officials, aid organizations, and staff coordinating the international response to the Ebola outbreak in West Africa…” (10/10).

U.S. Africa Command: United Assistance Team Makes Significant Strides
“…In just a few short weeks, the U.S. military has established the Joint Forces Command-United Assistance (JFC-UA) to support the comprehensive U.S. government response to the Ebola outbreak. United States Agency for International Development (USAID) remains the lead U.S. agency in charge of the U.S. response to the Government of Liberia’s request for assistance in containing the Ebola virus disease (EVD)…” (10/10).

Center for Global Development’s “Global Health Policy Blog”: Understanding the World Bank’s Estimate of the Economic Damage of Ebola to West Africa
Mead Over, senior fellow at CGD, and David Evans, senior economist at the World Bank, discuss the World Bank’s recently released report, titled “The Economic Impact of the 2014 Ebola Epidemic: Short and Medium Term Estimates for West Africa” (10/10).

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Women Are Key Partners In Development

Bill & Melinda Gates Foundation’s “Impatient Optimists”: Why Development Begins with Women
Melinda Gates, co-chair and trustee of the Bill & Melinda Gates Foundation, discusses the importance of involving women in development, writing, “Every day, all over the world, women and girls are proving that if we recognize them as vital partners in development, change is possible. The women and girls I meet are ready and willing to help drive development. But first, we have to make the effort to put them in the driver’s seat” (10/12).

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State Department Blog Posts, Press Release Discuss International Day Of The Girl Child

The U.S. Department of State’s “DipNote” blog features several posts about the International Day of the Girl Child, recognized on October 11, and U.S. Secretary of State John Kerry released remarks to honor the day.

DipNote: Celebrating the International Day of the Girl: Why Adolescent Girls are a Smart Investment
Catherine Russell, ambassasdor-at-large for global women’s issues, writes, “…Empowering adolescent girls — specifically by freeing them from violence and ensuring them an education — is key to building the future we all want…” (10/10).

DipNote: Let’s Confront, Not Ignore
Daniela Ligiero, senior gender adviser in the Office of the Global AIDS Coordinator, states, “…Every girl should be able to live her life free of gender-based violence. It is just that simple. Thankfully, the world is beginning to shine a light not only on the problem, but also on solutions. We have a long way to go, but if we confront rather than ignore the issue, we can build a brighter future for millions of girls” (10/11).

DipNote: The Marathon To Close the Gender Gap
Dorothy Shea, deputy principal officer at the Consulate General of the United States in Jerusalem, writes, “…Empowering women throughout the world has been a long-term goal of Secretary Kerry, as it was for former Secretary Clinton. Closing the gender gap will take time, but we must steadfastly move towards a more inclusive society if we want peace and prosperity…” (10/11).

U.S. Department of State: International Day of the Girl, October 11
“…International Day of the Girl reminds us of the need to recommit to investing in the world’s 850 million girls so that they can use their talents to contribute to their communities and countries. … By working together as a community of nations, we can build a world in which girls are not treated as property, chattel, or spoils of war, but rather as individuals with their own voice, talents, and freedom to realize their potential and contribute to our collective humanity…” (Kerry, 10/10).

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